CARDIOVASCULAR EFFECTS OF DILTIAZEM IN THE DOG

SUMMARY The effects of two bolus injections (0.2 mg kg−1) and two infusion rates (0.2 mg min−1 and 0.4 mg min−1) ofdiltiazem on global and regional left (LV) and right ventricular (RV) performance (ultrasonic dimension technique), on coronary (electromagnetic flow meters) and systemic haemodynamics, and on electrophysiology (PR, QRS, QTC intervals) were studied in eight open-chest dogs anaesthetized with droperidol and fentanyl. The two bolus injections of diltiazem resulted in plasma concentrations of 688 ± 115 and 650 ± 85 ng ml−1 (means ± SE), respectively, and caused substantial decreases in systemic and coronary vascular resistances, and in aortic pressure, and increases in LV segment shortening, stroke volume and aortic flow. Electro -physiological variables were little affected. At the low infusion rate (plasma concentration 140 ± 23 ng ml−1) coronary and systemic vaso-dilatation occurred, but global and regional RV and LV performance were little affected. PR interval increased by 15%. At the higher infusion rate (plasma concentration 282 ± 33 ng ml−1) coronary and systemic vasodilatation were maintained. Aortic pressure decreased slightly. Whereas LV end-diastolic and end-systolic dimensions remained unchanged, they increased in the RV. In addition, the PR interval increased by 35%, and three animals developed atrio-ventricular block type I. The data indicate that diltiazem is a potent coronary and systemic vasodilator with little effect on global RV and L V performance. However, at a higher infusion rate RV dimensions clearly tend to increase, and conduction abnormalities develo

Electrometer system measures nanoamps at high voltage

Floating electrometer eliminates major source of error since any leakage from electrometer case, which is at high voltage, appears only as load on high voltage supply and not as part of current being measured. Commands to and data from floating electrometer are transferred across high voltage interface by means of optical channels

Cost-effectiveness of financial incentives to promote adherence to depot antipsychotic medication: economic evaluation of a cluster-randomised controlled trial

Background: Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods: Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings: Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5%at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation: Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration: ISRCTN.com 7776928

Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countries

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Understanding psychiatric institutionalization: a conceptual review

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

From Teamchef Arminius to Hermann Junior: glocalised discourse about a national foundation myth

If for much of the nineteenth and twentieth centuries, the ‘Battle of the Teutoburg Forest’, fought in 9 CE between Roman armies and Germanic tribes, was predominantly a reference point for nationalist and chauvinist discourses in Germany, the first decade of the twenty-first century has seen attempts to link public remembrance with local/regional identities on the one hand and international/intercultural contact on the other. In the run up to and during the ‘anniversary year’ of 2009, German media, sports institutions and various other official institutions articulating tourist, economic and political interests attempted to create a new ‘glocalised’ version of the public memory of the Teutoburg battle. Combining methods of Cognitive Linguistics and Critical Discourse Analysis, the paper analyses the narrative and argumentative topoi employed in this re-orientation of public memory, with a special emphasis on hybrid, post-national identity-construction. Das zweitausendjährige Gedenkjahr der „Schlacht im Teutoburger Wald“ im Jahr 2009 bot eine günstige Gelegenheit, die bis in die zweite Hälfte des 20. Jahrhunderts dominante Tradition nationalistisch–chauvinistischer Deutungen des Sieges von germanischen Stämmen über drei römische Legionen zu korrigieren und zu überwinden. Der Aufsatz analysiert mit Hilfe diskurslinguistischer Methoden die Anstrengungen regionaler Institutionen und Medien, die nationale Vereinnahmung des historischen Gedenkens kritisch zu thematisieren sowie neue, zum eine lokal situierte, zum andern international orientierte Identifikationsangebote anzubieten. Die Analyse zeigt, dass solche „de-nationalisierten“ Identifikationsangebote zwar teilweise auch früher verwendet wurden, aber heutzutage rekontextualisiert und auf innovative Weise in den Vordergrund gestellt werden

Effect of mulberry fruit extract on glucose fluxes after a wheat porridge meal:a dual isotope study in healthy human subjects

Background: Previous research has shown the efficacy of mulberry extracts for lowering post-prandial glucose (PPG) responses. The postulated mechanism is slowing of glucose absorption, but effects on glucose disposal or endogenous production are also possible. This research assessed the effect of a specified mulberry fruit extract (MFE) on these three glucose flux parameters. Methods: The study used a double-blind, randomized, controlled, full cross-over design. In 3 counter-balanced treatments, 12 healthy adult male subjects, mean (SD) age 24.9 (2.50) years and body mass index 22.5 (1.57) kg/m2, consumed porridge prepared from 13C-labelled wheat, with or without addition of 0.75 g MFE, or a solution of 13C-glucose in water. A co-administered 2H-glucose venous infusion allowed for assessment of glucose disposal. Glucose flux parameters, cumulative absorption (time to 50% absorption, T50%abs), and PPG positive incremental area under the curve from 0 to 120 min (+iAUC0–120) were determined from total and isotopically labelled glucose in plasma. As this exploratory study was not powered for formal inferential statistical tests, results are reported as the mean percent difference (or minutes for T50%abs) between treatments with 95% CI. Results: MFE increased mean T50%abs by 10.2 min, (95% CI 3.9–16.5 min), and reduced mean 2 h post-meal rate of glucose appearance by 8.4% (95% CI −14.9 to −1.4%) and PPG + iAUC0-120 by 11% (95% CI −26.3 to −7.3%), with no significant changes in glucose disposal or endogenous production. Conclusions: The PPG-lowering effect of MFE is primarily mediated by a reduced rate of glucose uptake.</p